Medically reviewed by, Russell Braun RPH
Do dry eyes impact your quality of life? Have you spent years trying to treat them yourself with over the counter medications? Did you decide the time has come to give Xiidra a try?
Wouldn’t it be great to have a day where your eyes did not sting, burn and itch? It would be great if they didn’t look so red all the time and to get rid of that stringy mucus in the corner of your eye. The good news is, Xiidra can probably help you. The bad news comes when you find out how expensive it can be!
Did that lead you to searching for a Xiidra coupon?
What is Xiidra?
Xiidra (liftegrast) 5% is an eye preparation available in single use containers. It is used to treat chronic dry eye disease also known as DED.
The drops are used twice a day 12 hours apart and over time may help your eyes naturally produce more tears. This helps keep the eyes moist and prevents the symptoms of dry eye.
How does Xiidra work?
Liftegrast the active ingredient in Xiidra, suppresses the T-cells of your immune system. This prevents certain chemicals from being released that cause inflammation. These chemicals are thought to cause chronic dry eyes. The exact way Xiidra alters the immune system to heal dry eye disease is unknown.
It is important to have a general idea how the drug works when you compare it to other drugs for dry eyes. Over the counter options typically do not work in this same way.
Xiidra is available by prescription only and should only be used under the direction of your doctor and pharmacist.
Learn more about how to deal with dry eyes without drugs in this great resource written by Dr. Robert Latkany. The more you understand about what makes dry eyes worse off, the better you will be both with and without medication.
Are there coupons for Xiidra?
Most brand name drugs will have a copay coupon savings card available. The coupon will take the copay (or deductible amount owed per prescription) from whatever your insurance sets it at, and reduce it down to a specific amount set by the manufacturer. An example would be the copay is $150 for brand drugs but the Xiidra coupon pays $145 of that cost leaving the patient with a small copay of $5.
According to the Xiidra website, you could pay:
as little as for a 30 day prescription
On the surface the Xiidra copay coupon savings card sounds great, pay just a few dollars per month. However, beware of a few very important details that could cost you big bucks in the long run.
1. The higher your income or type of insurance, the higher the amount you will have to pay for each copay. Consequently, not everyone will get the lowest copay of $5.
2. Xiidra copay coupon savings card has a maximum amount it will pay. The maximum amount is $250 for 30 days and $750 for 90 days supply. Typically a yearly max will apply as well, but is not provided publicly. Therefore asking the manufacturer before using is critical.
3. Copay coupon savings most likely DO NOT apply toward deductibles.
4. All patients who are covered by government insurance are ineligible. Therefore, Medicare, Medicaid, Tricare and any other government insurance are ineligible.
5. Uninsured patients are also not eligible, you can only use the Xiidra coupon WITH insurance.
6. Xiidra coupon can’t be combined with other discounts or coupons.
7. Only participating pharmacies will accept the Xiidra coupon.
How Drug copay coupon card programs work
It is important to understand why Novartis, the manufacturers of Xiidra offers a copay coupon program. Here is a quick breakdown on why copay coupons, also called savings cards even exist.
To understand more on drug copay coupon cards click here.
Steps to take before using a Xiidra coupon
How much does Xiidra cost?
Before we look at the actual cost of Xiidra it is important to take a step by step approach to finding the best price treatment for your dry eyes. I will walk you through the steps to take in order and then explain how much Xiidra costs and when the coupon should be used.
#1 Is there a generic version of Xiidra?
Today Xiidra is brand name drug only. The generic, liftegrast can’t be manufactured and sold until the patents expire for Xiidra. Lawyers working for Novartis have been finding new ways to protect the patent. Consequently, Xiidra will not be generically available until 2029.
#2 Are there therapeutic alternatives to Xiidra?
A therapeutic alternative is a drug that had different chemical contents, but has the same effects as other drugs for treating a condition. Xiidra has no generic alternative, but does have some therapeutic alternatives. Some of these therapeutic alternatives have generics which also means they will be substantially cheaper. Before trying a Xiidra coupon make sure to try one or more of the alternatives that have generics listed in table 1 below.
Prescription therapeutic alternatives
Some of the therapeutic alternatives to Xiidra that are prescription only and also don’t have generics. Make sure to ask your doctor about the options that have lower cost generics available.
|Brand name||Generic name||Sold generically?|
|FML / Flarex||Fluorometholone||Yes|
Over the counter therapeutic alternatives
Some of these over the counter options are available in both over the counter and prescription strengths. The good news, they are all have generics available! Again, talk to your doctor about the dose and frequency for which to take these medications based on symptoms. Sometimes using more than one medication that work in different ways in the body can provide relief. Ask your doctor if that is something you should try.
Some people with dry eyes have problems with medications that contain preservatives. On the list below, Soothe is the only drop that doesn’t contain preservatives. Again discuss this with your doctor and see what may be best for you.
|Brand name||Generic Name|
|Artificial tears||Carboxymethyl cellulose and polyvinyl alcohol|
|Refresh tears||Carboxymethyl cellulose|
|Systane||Propylene glycol and polyethylene glycol|
Finally, keep in mind that Xiidra or other medications may not alleviate their symptoms on their own. Xiidra could potentially be used with another dry eye medication that works in a different way at the same time. Ask your doctor before combining medications like this, but know it could prove quite useful.
# 3 Utilize drug discount programs to research alternatives
Drug discount programs are available today in a variety of formats. It is imporant to understand the differences in a drug discount card or app in contrast to the Xiidra coupon. These discount programs negotiate prices with one or all of the following:
- Pharmacy benefit managers (PBM’s)
- Drug manufacturers
Most work with pharmacies who want to show up in the search function on the discount programs website or mobile application. Therefore, patients can see a discounted price the pharmacy negotiates with the discount program. Keep in mind these can not be used with insurance, but instead when the negotiated price is better than the price with insurance. Most people would not think the discount price could be better than insurance, but many times it is. A few of the major discount programs available today include:
Xiidra has a high list price and because of that drug discount programs are not going to make the price tag manageable for most people. The best practice is to use drug discount programs to see how much the alternatives to Xiidra with generics available (listed in table 1 & 2 above) cost and talk to your doctor about those options.
#4 What is the cost of Xiidra without insurance?
According to the Novartis website, Xiidra’s full list price is $522.21. That price is the full cash price, without any insurance or drug discount program discount.
As you can see at that price, that cost each month can add up quickly. Also, remember a Xiidra coupon is not able to be used unless you have insurance!
Again, checking to see if the therapeutic alternatives that have generics are cheaper without insurance is a good idea. Many times your insurance copay might be more than what you can buy them for from the pharmacy paying cash.
#5 Is Xiidra covered by insurance?
What can be done if a therapeutic alternative is not an option? Check with your insurance to see if Xiidra is on formulary. If indeed it is on formulary it will have a more favorable out of pocket cost for you in the form of lower copay, deductible or coinsurance.
Check with your pharmacist to calculate your out of pocket cost using your insurance. Costs can vary widely depending on your insurance plan.
Also, the type of insurance plan you have will make a big difference in cost.
- High deductible health plans (HDHP) will have a large deductible that will come from your pocket or the Xiidra coupon.
- Preferred provider organizations (PPO) will have a set copay amount, Xiidra coupon can also be used for that copay.
HDHP vs. PPO explains more on the differences between these types of insurance.
#6 Is Xiidra covered by Medicare?
Xiidra ranges from being covered as a preferred drug all the way to being not covered by Medicare. The only way to know for sure in your situation is to go to Medicare.gov and use the plan compare tool. Follow the prompts and provide your basic information about prescriptions and pharmacy preference. Next, you will see many details about coverage, focus in on two things:
- Drug deductible
- Pharmacies & prescription drugs
Clicking on the link under pharmacies & prescription drugs will show you exactly how much Xiidra will cost you monthly and yearly.
Remember, Xiidra copay coupon can NOT be used for Medicare!
Medicare also offers the Extra Help subsidy, for lower income people. Everyone on Medicare should check to see if they are eligible, because investigating costs you nothing. Consequently, if you are eligible the savings could be huge.
#7 Are there samples available?
Before trying any new medication the best practice is to try samples. Brand name drugs like Xiidra will have samples that the manufacturer provides to doctors. Sampling the medication allows a trial where it can be determined if the medication is going to be well tolerated or not. For the best outcome I recommend bullet journaling on medication effects.
Xiidra like other medications for dry eyes can take a few days to a week to determine if it is working. Ask for enough samples to last at least two weeks. This provides enough time to determine effectiveness, side effects and allows time to get a prescription filled.
#8 Patient Assistance Programs (PAPs)
In addition to offering the Xiidra coupon, a patient assistance program is available through the Novartis Patient Assistance Foundation. The program is designed to help patients get Xiidra at low or no cost.
Can I get Xiidra for free?
Many patients who receive funding through a PAP may get medication for free. You have to check with Novartis as this is determined on a case by case basis.
To be eligible for this assistance patients must meet the following criteria:
- Reside in the United States, Puerto Rico or the U.S. Virgin Islands
- Those with insurance can contact program to determine if eligible
- Medicare Part D eligibility contact the program for details
- Income limit below 600% of the Federal Poverty Level (FPL)
Anyone who is close to the FPL cutoff level should still apply. The applications are approved on a case by case basis and anyone slightly over that mark could still get assistance.
The Novartis Patient Assistance Foundation form for Xiidra can be downloaded here. A doctor must complete the paperwork sign and return to Novartis. The optimal time to complete the process is right after the doctor provides you with samples. The delivery of the medication is typically within 10 days. That should ensure the assistance is available when you need to get a prescription filled.
State Prescription Assistance Programs (SPAPs)
Some states have there own state pharmaceutical assistance programs that are run by the state. They normally focus on low-income patients and also offer some type of Medicare Part D coverage as the Xiidra PAP program may not apply to Medicare enrollees.
A state by state listing of SPAPs can be searched on Medicare.gov.
#9 How do I get a Xiidra copay coupon savings card?
After trying the steps mentioned above, the Xiidra coupon may be the best option because it does lower copay or deductible costs. Once you confirm that Xiidra worked and was well tolerated, a coupon can be obtained here.
Novartis claims that patients can get Xiidra for as low as $5 dollars for a 30 day supply or $15 for a 90 day supply using the Xiidra coupon. Please keep in mind this will be based on income and other factors so not everyone will get the $5 or $15 copay.
The Xiidra coupon also has a maximum payout and is only good for 12 fills of a 30 day prescription or 4 fills of a 90 day supply. Maxium payouts are:
- $250 for 30 day supply
- $750 for 90 day supply
Therefore if you have a high deductible health plan instead of $5, you may end up owing $272.21!
Calculation: $522.21 net cost – $250 copay coupon card = 272.21 out of pocket to you!
Finally, you may be able eligible to get a new savings coupon the next year that is good for another 12 fills or the maximum payout amount.
Beware of copay accumulator programs!
Many insurance companies have added a feature called a copay accumulator, because high deducible health plans are becoming more common. This is a fancy term for counting how much of the deductible (or copay) was paid by the patient versus the copay coupon. When accumulators are used any amount paid by the copay coupon will NOT count toward the deductible.
For more information on these programs and an example that makes it easy to understand read my pharmacist tips on copay accumulator programs.
Click here to get Dr. Jason Reed’s exclusive list of medication questions you MUST ask your doctor, for FREE!
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